HomeMy WebLinkAboutBuilding Permit Application (2)DESIGNER/ENGINEER: — Not Applicable
Will
MORTGAGE COMPANY: Not Applicable
Name:
_
Name:
Address:
Address:
City: State:
City: State:
Zip: Phone
Zip: Phone:
FEE SIMPLE TITLE HOLDER: - Not Applicable BONDING-COMPANY: Not Applicable
Name: Name:
Address: Address:
City: City:
Zip' Phone: Zip: Phone:
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made`to obtain a permit to do the work and installation as indicated.
certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie County makes no representation that is granting a permit will authorize the permit. holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and-.review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen. rooms and accessory uses to another non-residential use
"WARNING T& OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING
TWICE FOR IMPROVEMENTS TO YOUR. PROPERTY. A NOTICE OF COMMENCEMENT MUST BE RECORDED AND
POSTED ON THE JOB SITE BEFORE THE -FIRST INSPECTION. IF YOU INTEND O OBTAIN FINANCING, CONSULT '
WITH YOUR LE R AN ATT RNEY BEFORE RECORDING YOUR NOTIC MENCEM "
tSjgn ture of'Owner/ Lessee/Contractor as Agent for Owner
ft-nature of Contractor/License Holde
STATE OF FLORIDA
STATE OF FLORIDA '�
COUNTY OF Q �'
n
COUNTY UU OF '" COL.
The forgoing instrument was acknowledged before me
this day of f 20� by
The fQ�oing instrument was acknowledge, d kefore me
__, _
this day of _tj 20'C¢�by
Name of person making statement.
Name of person making statement.
Personally Known OR Produced Identification
Personally Known OR Produced Identification
Type of identification
Type of Identification,^
Produced 1 _ bi
Produced / (
(Signature of Notary Pu&- State of Florida)
�A
(Signature of Notary PubU. - •
Commission No. o`ZPp',°
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L
eC-, ELLEN VAU7
Commission No. -• °=SCoe Nota HN
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REVIEWS FR tob. r @JIR
PLANS VEGETATION SEA TURTLE
COUNTER REVIE
REVIEW REVIEW REVIEW REVIEW
DATE
RECEIVED
PATE
COMPLETED
Rev.2/7/19